Debating Difficult and Emotive Midwifery Topics: 5 Strategies

Have you ever struggled with a midwifery debate, unsure whether to share your point of view or whether to leave it be?

Having run a 25,000ish member midwifery forum for ages, I’ve seen a lot of arguments. I’ve also been there for some fierce discussions in real life. And I''ve got stuff wrong (see point 4 below).

It’s important to know your take on debating because a) women depend on us advocating for them b) it's pretty easy to waste energy/get hurt.

In midwifery, it's all personal.

You also don't want to offend other staff, what you believe is lively discussion is a personal attack for someone else who's just been through something.

I definitely don't have all the answers but here's how I tend to wade in (or not...)

*This is my way of doing things. Yours might be different! Totally fine, let me know in a comment.

1. Decide Whether You Should Get Involved at All

When someone says something awful, or there's a debate already in session, check yourself before you wreck yourself.

Are you wanting to learn? Share your knowledge? Stand up for the women? Enjoy the art of debate?

Or does that quote about 'getting high on the fumes of self-righteousness' apply 😉

It’s easy to make this mistake online.

I’m passionate about the right to abortion, my novel is focussed around this.

But these days I try to understand people who have the opposite belief to me, sometimes their views are valuable in helping test mine, and people don't change their mind if you just tell them ‘you’re wrong' over and over.

2. Check Context

Sharing with an aspiring midwife that yes, women can make the choice to have an elective caesarean for no medical reason = great.

Discussing ‘This Is Going To Hurt’ especially the bit when the doctor says ‘home delivery is for pizza’ = good thing.

Getting into a debate with your a family member who's just said 'AT LEAST YOU KNOW YOU CAN GET PREGNANT' to a mutual friend having her second miscarriage...

Look, I know this isn't an empathetic thing to say. But taking it up with her then and there was a ***bag move on my part, probably more to do with me grieving than anything else.

You have to reliably stick up for what you believe in, but if you choose the wrong moment or voice, and shame people, they can’t hear you.

Use your life experience, gut instinct and what your Mum taught you about politeness to decide if this is an okay time to talk.

3. But Don’t Just Let Things Go

Midwifery topics are personal because they concern women’s decisions and the outcome for their family. We’re accountable for their well-being.

If a doctor/midwife/other person is not offering true informed consent…

...for instance saying ‘this baby can’t come out that way’ re breech

…. you can say something like ‘we both know that’s not true, should I get some information for us?’ (dive for AIMS leaflet.)

Then you can pick up the conversation later.

Notice you don’t say ‘that’s an appalling way to offer someone informed consent’.

It’s important to stay factual and have compassionate understanding, even if you really disagree. Otherwise they’ll just feel attacked.

Plus, no-one's better than anyone else: it's important for all of us to understand different points of view.

I like sociologist Brene Brown’s definition of civility for moments like this:

‘Civility is claiming and caring for one’s identity, needs and beliefs without degrading someone else’s in the process. It is about negotiating interpersonal power so everyone’s voice is heard, and nobody’s is ignored'

4. Know When to Leave

Basically, when there are threats or violence of dehumanisation, it’s time to walk away. The threat of physical violence is the first step in physical violence being committed (see 'Less Than Human', David Smith).

This can be overt, for instance if someone online threatens to beat you up (or rape you...it's lovely isn't it), block them and contact the authorities.

But it can be more subtle.

For instance, debating about termination of pregnancy is okay.

Deciding on whether the death penalty for termination of pregnancy might be an appropriate punishment, is not.

It might be you need to contact a manager or professional body about stuff like this.

We got this wrong in my midwifery forum the other day.

Trump’s government has been working on several states to try and get the death penalty for women having terminations.

We let a debate continue after a member suggested ‘a life for a life’ was an okay belief.

We were trying to be tolerant of opinions but we should have removed that comment and member immediately, there has to be a line where we protect people.

5. Be Kind

I'm actually quite good at this, I think it's one of the reasons I've managed to keep the midwifery forum going.

For instance, a recent passionate, angry response from a midwife was because she'd recently cared for a baby who'd died. Only by assuming there was more to the story and listening carefully to the midwife in question did we figure that out.

My Mum was a nurse who’s raised three kids who all went on to caring professions.

If we were involved in conflict at school her first response was ‘and what did you do? what’s your part in this?’

I’ve had to learn to stand up for myself 'manually' as an adult because anger doesn’t come naturally. This means I've been a target for bullying sometimes.

But I find it great for modding, because I always try and understand everyone’s point of view and be non-judgemental in my assumptions.

In an honest debate, think the most generous thing about whoever disagrees with you and you’ll get far more out of the process.

Differences of opinion are a good thing, they prove you’re not in an echo chamber. We know these are dangerous because they cause division rather than working together.

You have to be yourself. But you need to do it kindly.

And this is how I approach midwifery debate!

I’d love to hear from you, anything you’ve learnt from this you can implement?

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3 Responses

This is so helpful Ellie. It’s always hard for me to think when should I get involved and when I shouldn’t. Often for self care purposes. Good to have something to refer to in order to help me with this. Thanks.

This is a great topic Ellie, I think over the years I have learned to choose my battles wisely. I am a big believer in listening to all sides of an opinion. When we have passion about something whether it’s an ethics debate or a belief we have learned to adopt from our backgrounds and culture or life experiences, we need to be mindful we are all different and live and experience the world differently. Nothing in life is black and white and the middle ground is sometimes the best most effective place to fire from. I believe we should be true to ourselves but always remember what we say and how we say things can have positive and negative effects on others. We all get it wrong and can be insensitive to others, not intentionally meaning to cause harm or upset or sometimes we do which usually stems from sin or upset within the person and gets projected. I think when we are honest and kind and admit when we make mistakes and learn something from them we keep moving and learning and evolving into the people/person we want to be and express to the world. It’s a huge subject on all levels and one that should be spoken about xx